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| 1 | Contrast-enhanced ultrasonography parameters in neural network diagnosis of liver tumors显示文摘AIM:To study the role of time-intensity curve(TIC) analysis parameters in a complex system of neural networks designed to classify liver tumors.METHODS:We prospectively included 112 patients with hepatocellular carcinoma(HCC)(n = 41),hypervascular(n = 20) and hypovascular(n = 12) liver metastases,hepatic hemangiomas(n = 16) or focal fatty changes(n = 23) who underwent contrast-enhanced ultrasonography in the Research Center of Gastroenterology and Hepatology,Craiova,Romania.We recorded full length movies of all contrast uptake phases and post-processed them offline by selecting two areas of interest(one for the tumor and one for the healthy surrounding parenchyma) and consecutive TIC analysis.The difference in maximum intensities,the time to reaching them and the aspect of the late/portal phase,as quantified by the neural network and a ratio between median intensities of the central and peripheral areas were analyzed by a feed forward back propagation multi-layer neural network which was trained to classify data into five distinct classes,corresponding to each type of liver lesion.RESULTS:The neural network had 94.45% training accuracy(95% CI:89.31%-97.21%) and 87.12% testing accuracy(95% CI:86.83%-93.17%).The automatic classification process registered 93.2% sensitivity,89.7% specificity,94.42% positive predictive value and 87.57% negative predictive value.The artificial neural networks(ANN) incorrectly classified as hemangyomas three HCC cases and two hypervascular metastases,while in turn misclassifying four liver hemangyomas as HCC(one case) and hypervascular metastases(three cases).Comparatively,human interpretation of TICs showed 94.1% sensitivity,90.7% specificity,95.11% positive predictive value and 88.89% negative predictive value.The accuracy and specificity of the ANN diagnosis system was similar to that of human interpretation of the TICs(P = 0.225 and P = 0.451,respectively).Hepatocellular carcinoma cases showed contrast uptake during the arterial phase followed by wash-out in the portal and first seconds of the late phases.For the hypovascular metastases did not show significant contrast uptake during the arterial phase,which resulted in negative differences between the maximum intensities.We registered wash-out in the late phase for most of the hypervascular metastases.Liver hemangiomas had contrast uptake in the arterial phase without agent wash-out in the portallate phases.The focal fatty changes did not show any differences from surrounding liver parenchyma,resulting in similar TIC patterns and extracted parameters.CONCLUSION:Neural network analysis of contrastenhanced ultrasonography-obtained TICs seems a promising field of development for future techniques,providing fast and reliable diagnostic aid for the clinician. | Costin Teodor Streba Mihaela Ionescu Dan Ionut Gheonea Larisa Sandulescu Tudorel Ciurea Adrian Saftoiu Cristin Constantin Vere Ion Rogoveanu | 2012 | World Journal of Gastroenterology2012，18，32： | 11 |
| 2 | Real-time sono-elastography in the diagnosis of diffuse liver diseases显示文摘AIM: To analyze whether computer-enhanced dynamic analysis of elastography movies is able to better characterize and differentiate between different degrees of liver fibrosis. METHODS: The study design was prospective. A total of 132 consecutive patients with chronic liver diseases and healthy volunteers were examined by transabdominal ultrasound elastography. All examinations were done by two doctors.RESULTS: Due to the limitations of the method, we obtained high-quality elastography information in only 73.48% of the patients. The κ-means clustering method was applied to assess the inter-observer diagnosis varia- bility, which showed good variability values in accordance with the experience of ultrasound examination of every observer. Cohen’sκ test indicated a moderate agreement between the study observers (κ = 0.4728). Furthermore, we compared the way the two observers clustered the patients, using the test for comparing two proportions (t value, two-sided test). There was no statistically significant difference between the two physicians, regardless of the patients’ real status. CONCLUSION: Transabdominal real-time elastography is certainly a very useful method in depicting liver hard- ness, although it is incompletely tested in large multicenter studies. | Dan Ionut Gheonea Adrian S ǎftoiu Tudorel Ciurea Florin Gorunescu Sevastita Iordache Gabriel Lucian Popescu Smaranda Belciug Marina Gorunescu Larisa Sǎndulescu | 2010 | World Journal of Gastroenterology2010，16，14： | 9 |
| 3 | Confocal laser endomicroscopy and immunoendoscopy for real-time assessment of vascularization in gastrointestinal malignancies显示文摘Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor prognosis.Angiogenesis plays a crucial part in tumor growth and metastasis,with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network.Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents.Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination(immunoendoscopy),as a future challenge,will add functional analysis to the morphological aspect of the neoplastic process.This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization,resulting in a broad spectrum of potential clinical applications,and also preclinical research that could be translated to human studies. | Dan Ionut Gheonea Tatiana Crtnǎ Tudorel Ciurea Carmen Popescu Anca Bǎdǎrǎu Adrian Sǎftoiu | 2011 | World Journal of Gastroenterology2011，17，1： | 6 |
| 4 | Autofluorescence imaging and magnification endoscopy显示文摘It is well known that angiogenesis is critical in the transition from premalignant to malignant lesions.Consequently,early detection and diagnosis based on morphological changes to the microvessels are crucial.In the last few years,new imaging techniques which utilize the properties of light-tissue interaction have been developed to increase early diagnosis of gastrointestinal(GI) tract neoplasia.We analyzed several 'red-flag' endoscopic techniques used to enhance visualization of the vascular pattern of preneoplastic and neoplastic lesions(e.g.trimodal imaging including autofluorescence imaging,magnifying endoscopy and narrow band imaging).These new endoscopic techniques provide better visualization of mucosal microsurface structure and microvascular architecture and may enhance the diagnosis and characterization of mucosal lesions in the GI tract.In the near future,it is expected that trimodal imaging endoscopy will be practiced as a standard endoscopy technique as it is quick,safe and accurate for making a precise diagnosis of gastrointestinal pathology,with an emphasis on the diagnosis of early GI tract cancers.Further large-scale randomized controlled trials comparing these modalities in different patient subpopulations are warranted before their endorsement in the routine practice of GI endoscopy. | Monalisa Filip Sevastita Iordache Adrian Sǎftoiu Tudorel Ciurea | 2011 | World Journal of Gastroenterology2011，17，1： | 5 |
| 5 | Neural Network Analysis of Dynamic Sequences of EUS Elastography Used for the Differential Diagnosis of Chronic Pancreatitis and Pancreatic Cancer显示文摘 | Adrian Saftoiu Peter Vilmann Florin Gorunescu Dan Ionut Gheonea Marina Gorunescu Tudorel Ciurea Gabriel Lucian Popescu Alexandru Iordache Sevastita Iordache | 2008 | Gastrointestinal Endoscopy2008，，5： | 2 |
| 6 | Combined contrast-enhanced power Doppler and real-time sonoelastography performed during EUS, used in the differential diagnosis of focal pancreatic masses (with videos)显示文摘 | Adrian S?ftoiu Sevasti?a Iordache Dan Ionu? Gheonea Carmen Popescu Anca Malo? Florin Gorunescu Tudorel Ciurea Alexandru Iordache Gabriel Lucian Popescu Cǎtǎlin Manea | 2010 | Gastrointestinal Endoscopy2010，，4： | 2 |
| 7 | Combined contrast-enhanced power Doppler and real-time sonoelastography performed during EUS, used in the differential diagnosis of focal pancreatic masses (with videos)显示文摘 | Adrian S?ftoiu Sevasti?a Iordache Dan Ionu? Gheonea Carmen Popescu Anca Malo? Florin Gorunescu Tudorel Ciurea Alexandru Iordache Gabriel Lucian Popescu Cǎtǎlin Manea | 2010 | Gastrointestinal Endoscopy2010，，4： | 1 |
| 8 | Neural network analysis of dynamic sequences of EUS elastography used for the differential diagnosis of chronic pancreatitis and pancreatic cancer显示文摘 | Adrian S?ftoiu Peter Vilmann Florin Gorunescu Dan Ionu? Gheonea Marina Gorunescu Tudorel Ciurea Gabriel Lucian Popescu Alexandru Iordache Hazem Hassan Sevasti?a Iordache | 2008 | Gastrointestinal Endoscopy2008，，6： | 1 |
| 9 | Faculty and peer influences on academic integrity:College cheating in Romania显示文摘 | Teodorescu Daniel Tudorel Andrei | 2009 | Higher Education2009，，57： | 1 |
| 10 | Econo- metric models used in the analysis of the informal economy at the regional level 显示文摘 | Tudorel Andrei Bogdan Oancea StelianStancu | 2009 | InformaticaEconomica2009，13，3： | 1 |
| 11 | Faculty and Peer Influ- ences on Academic Integrity:College Cheating in Romania 显示文摘 | Daniel Teodorescu Tudorel Andrei | 2009 | High Education2009，，3： | 1 |
| 12 | Efficacy of an Artificial Neural Network–Based Approach to Endoscopic Ultrasound Elastography in Diagnosis of Focal Pancreatic Masses显示文摘 | Adrian S?ftoiu Peter Vilmann Florin Gorunescu Jan Janssen Michael Hocke Michael Larsen Julio Iglesias–Garcia Paolo Arcidiacono Uwe Will Marc Giovannini Cristoph F. Dietrich Roald Havre Cristian Gheorghe Colin McKay Dan Ionu? Gheonea Tudorel Ciurea | 2012 | Clinical Gastroenterology and Hepatology2012，，1： | 1 |
| 13 | Faculty and peer influences on academic integrity: College cheating in Roma- nia 显示文摘 | Teodorescu Daniel and Tudorel Andrei | 2009 | Higher Education2009，，57： | 1 |
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